Acceptance and Commitment Therapy and nicotine patch for smokers with bipolar disorder: preliminary evaluation of in-person and telephone-delivered treatment
Open accessAbstract
OBJECTIVES: People with bipolar disorder are two to three times more likely to smoke and 50% less likely to quit than the general population. New treatments are needed to improve smoking cessation outcomes in this group. The study aim was to develop and pilot test a novel cessation intervention for smokers with bipolar disorder using Acceptance and Commitment Therapy (ACT) combined with nicotine patches. METHODS: The ten-session ACT intervention was initially evaluated as in-person, individual counseling (n = 10), then as telephone-delivered counseling (n = 6). Participants were adult smokers with no more than mild current symptoms of bipolar disorder. RESULTS: For the in-person protocol, end-of-treatment outcomes were: 80% retention, 40% of participants with carbon monoxide (CO)-verified seven-day point prevalence abstinence (PPA), 90% satisfied with treatment, 8.3 of ten sessions attended, and 54% increase in acceptance of cravings to smoke (i.e., ACT's theory-based change process) from baseline. The seven-day PPA at one-month follow-up was 30%. For the telephone protocol, end-of-treatment outcomes were: 67% retention, 33% reporting seven-day PPA, 100% satisfied with treatment, 6.7 of ten treatment calls completed, and 55% increase in acceptance from baseline. At one-month follow-up, seven-day PPA was 17%. The proportion of treatment completers who used at least 80% of the nicotine patches was 62.5% for the in-person protocol and 0% for the telephone protocol. CONCLUSIONS: Both in-person and telephone-delivered ACT were feasible. Despite low adherence to nicotine patches, the intervention showed preliminary evidence of facilitating quitting and impacting ACT's change mechanism. A randomized, controlled trial of this targeted ACT intervention is now needed.
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In an ACT protocol for smokers with comorbid mild bipolar I or bipolar II disorder, four-week abstinence rates were 30% for the in-person treatment and 17% for the telephone protocol group.
“After the specific intervention, four-week abstinence rates were 30% for the in-person treatment and 17% for the telephone protocol group.”
From The detrimental effects of smoking on the course and outcome in adults with bipolar disorder—A narrative review (2023) · cites this paper as [86]
In both ACT protocols, at least 50% of participants managed to reduce the number of cigarettes smoked per day by ≥50%.
“Furthermore, in both protocols, at least 50% of participants managed to reduce number of cigarettes smoked per day by ≥50%.”
From The detrimental effects of smoking on the course and outcome in adults with bipolar disorder—A narrative review (2023) · cites this paper as [86]
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- Authors
- Heffner, J. L., McClure, J. B., Mull, K. E., Anthenelli, R. M., & Bricker, J. B.
- Affiliations
- Fred Hutch Cancer Center (US)
- Kaiser Permanente Washington Health Research Institute (US)
- University of California San Diego (US)
- University of Washington (US)
- Corresponding author
- Heffner, Jaimee L
- Venue
- Bipolar Disorders
- Publisher
- Wiley
- Published
- 2015-04-25
- Volume
- 17
- Issue
- 5
- Pages
- 560-566
- ISSN
- 1398-5647 (ISSN-L)
- 1399-5618
- PMC
- PMC4526426
- OpenAlex
- W2159604744
- Cited by
- 24
- References
- 28
- Citations by year
- 2026: 2 · 2025: 1 · 2023: 8 · 2022: 2 · 2021: 2 · 2020: 1 · 2019: 3 · 2018: 4 · 2015: 1
- FWCI
- 1.23
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Bipolar Disorders (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- eScholarship (California Digital Library) (submittedVersion)
- Funders
- National Institutes of Health (K23DA026517)
- Topics
- Health Sciences › Medicine › Physiology › Smoking Behavior and Cessation
- Social Sciences › Psychology › Clinical Psychology › Mindfulness and Compassion Interventions
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Keywords
- acceptance and commitment therapy, nicotine patch, smoking cessation, bipolar disorder, in-person counseling, treatment retention, pilot intervention
- MeSH terms
- Adult, Aged, Bipolar Disorder, Female, Humans, Male, Middle Aged, Pilot Projects, Smoking, Telephone, Tobacco Use Disorder, Smoking Cessation, Treatment Outcome, Patient Satisfaction, Tobacco Use Cessation Devices, Acceptance and Commitment Therapy
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